Journal Article

Advances in the clinical management of type 2 diabetes: a brief history of the past 15 years and challenges for the future

Sattar, Naveed

2019

Overview

Remarkable progress has been made in some aspects of diabetes care over the last 15 years, but there have also been a rising number of challenges that differ between high and low-income countries. In high-income countries, a substantial increase in the use of preventative drugs for cardiovascular disease has lowered vascular complications and improved diabetes survival. More recently, new classes of diabetes drugs have emerged that can variably lower cardiovascular outcomes, new-onset heart failure and slow renal decline, thereby meaningfully increasing the diabetes armoury that should help patients to live even longer lives and with fewer complications. At the other end of the disease spectrum, we can now better prevent diabetes in people who are at elevated risk of developing it, whereas other new research has shown that diabetes remission is possible when lifestyle changes are made in the early years after diagnosis. The downside is that more people than ever before have type 2 diabetes, so despite such progress in high-income countries, the absolute burden of disease is rising. Furthermore, it is rising even faster in low and middle-income countries, where rising adiposity is driving a tidal wave of new diabetes cases; yet, healthcare systems are less able to cope, lacking sufficient drugs, trained personnel and integrated care systems. Thus, despite advances, the future challenges from rising diabetes rates worldwide are daunting.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adipose tissue / Adiposity / Biomedicine / Cardiovascular disease / Cardiovascular diseases / Care and treatment / Celebrating the past 15 years of medicine: BMC Medicine anniversary Editorials / Complications / Complications and side effects / Congestive heart failure / Correspondence / Developing countries / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - therapy / Diabetes therapy / Drugs / Forecasting / Forecasts and trends / Glycaemia / Health aspects / Health care / Health risk assessment / Heart failure / High income / Humans / Hypoglycemic agents / Income / Liraglutide / Medicine / Medicine & Public Health / Mortality / National libraries / Pharmaceutical industry / Prevalence / Remission / Renal failure / Risk factors / Saxagliptin / Statistics / Tidal waves / Time Factors / Tsunamis / Type 2 diabetes / Writers